NPI | 1114585163 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
Additional Taxonomies | 171W00000X Contractor (Licence: ID RCT47478) |
171WH0202X Contractor, Home Modifications (Licence: ID RCT47478) | |
172A00000X Driver | |
251B00000X Case Management | |
347C00000X Private Vehicle | |
Enumeration Date | 2019-06-04 |
Last Update Date | 2019-06-26 |