| NPI | 1932378387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: MA 1622) |
| Additional Taxonomies | 2279H0200X Respiratory Therapist, Registered, Home Health |
| Enumeration Date | 2008-02-29 |
| Last Update Date | 2009-06-17 |