| NPI | 1023490109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 22070) |
| Additional Taxonomies | 341600000X Ambulance |
| 3416L0300X Ambulance Land Transport | |
| 343800000X Secured Medical Transport (VAN) | |
| 343800000X Secured Medical Transport (VAN) (Licence: NC 465435628) | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 347B00000X Bus | |
| 347B00000X Bus (Licence: NC 465435628) | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2023-06-27 |