| NPI | 1912265281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 227800000X Respiratory Therapist, Certified (Licence: FL TT1691) |
| Additional Taxonomies | 227800000X Respiratory Therapist, Certified (Licence: GA TT1691) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2012-04-24 |