NPI | 1205302783 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) (Licence: VA 723) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001243079) |
Enumeration Date | 2018-10-22 |
Last Update Date | 2018-12-21 |