| NPI | 1205383262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) (Licence: MI L10941) |
| Additional Taxonomies | 172A00000X Driver (Licence: MI L10941) |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2016-09-07 |