| NPI | 1598359762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: CO 31698277-0000) |
| Enumeration Date | 2021-02-26 |
| Last Update Date | 2021-02-26 |