| NPI | 1083378095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 341600000X Ambulance |
| 3416A0800X Ambulance, Air Transport | |
| 3416L0300X Ambulance, Land Transport | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2021-10-26 |
| Last Update Date | 2021-10-26 |