| NPI | 1871023036 |
|---|---|
| Professional Name | N/A N/A N/A |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2278E0002X Respiratory Therapist, Certified, Emergency Care (Licence: OH 14150) |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2022-07-21 |