| NPI | 1750626784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 347C00000X Private Vehicle |
| Additional Taxonomies | 133N00000X Nutritionist |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies | |
| 332U00000X Home Delivered Meals | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2012-12-03 |
| Last Update Date | 2012-12-03 |