NPI | 1861164162 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies | |
Enumeration Date | 2021-10-04 |
Last Update Date | 2021-10-04 |