| NPI | 1093883712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 251J00000X Nursing Care |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2011-12-20 |