NPI | 1114265485 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: ID DME20447) |
Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: ID DME20447) |
Enumeration Date | 2013-01-22 |
Last Update Date | 2013-01-22 |