| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
|
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| 332BD1200X Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies |
| 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| Enumeration Date | 2018-08-23 |
| Last Update Date | 2018-08-23 |