| NPI | 1649439035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies (Licence: PR 4616650) |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2008-06-02 |