| NPI | 1881464519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 227900000X Respiratory Therapist, Registered (Licence: CA 42870) |
| Enumeration Date | 2024-01-04 |
| Last Update Date | 2024-02-06 |