| NPI | 1407192057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 171WH0202X Contractor Home Modifications |
| 227900000X Respiratory Therapist, Registered (Licence: 2357) | |
| Enumeration Date | 2012-12-28 |
| Last Update Date | 2012-12-28 |