| NPI | 1013771658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| 172A00000X Driver | |
| Enumeration Date | 2024-02-13 |
| Last Update Date | 2024-02-13 |