NPI | 1801645379 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 8135751161) |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
Enumeration Date | 2024-05-16 |
Last Update Date | 2024-05-16 |