| NPI | 1073725974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 332BD1200X Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies |
| 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies | |
| 341600000X Ambulance | |
| 343800000X Secured Medical Transport (VAN) | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2008-06-26 |