| NPI | 1740806769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MA CS029015) |
| Additional Taxonomies | 251B00000X Case Management |
| 251J00000X Nursing Care | |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2020-09-02 |