| NPI | 1831290873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 2930) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AZ 7057360001) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AZ 7034950001) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AZ 7045160001) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AZ 6748310001) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AZ 7629170001) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AZ 7047150001) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AZ 7209350001) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AZ 7046960001) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2018-09-14 |