| NPI | 1528230760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332BN1400X Durable Medical Equipment & Medical Supplies Nursing Facility Supplies |
| Additional Taxonomies | 332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2008-03-27 |