NPI | 1962682419 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
Enumeration Date | 2007-11-13 |
Last Update Date | 2008-03-10 |