# AL FANTASIA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1962023093
- **Gender:** Man
- **Credential:** RRT-NPS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 227900000X | Registered Respiratory Therapist | RT2863 | MA | Yes |
| 2279C0205X | Critical Care Registered Respiratory Therapist | RT2863 | NULL | — |
| 2279E0002X | Emergency Care Registered Respiratory Therapist | RT2863 | MA | — |
| 2279P3900X | Neonatal/Pediatric Registered Respiratory Therapist | RT2863 | NULL | — |

## Other

- **Enumeration date:** 04/29/2020
- **Last updated:** 04/29/2020