| NPI | 1023834538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 171WH0202X Contractor, Home Modifications |
| 172A00000X Driver | |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2024-11-29 |
| Last Update Date | 2024-11-29 |