| NPI | 1023659075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic |
| 343800000X Secured Medical Transport (VAN) | |
| 344600000X Taxi | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2019-10-01 |
| Last Update Date | 2019-10-01 |