| NPI | 1154283364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343800000X Secured Medical Transport (VAN) |
| Additional Taxonomies | 347C00000X Private Vehicle |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2025-11-25 |
| Last Update Date | 2025-11-25 |