| NPI | 1306636477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3416L0300X Ambulance, Land Transport |
| Additional Taxonomies | 251E00000X Home Health |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 333600000X Pharmacy | |
| Enumeration Date | 2025-05-10 |
| Last Update Date | 2025-05-10 |