| NPI | 1336430677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies (Licence: CA RCP9700) |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2011-04-20 |