| NPI | 1215685771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) (Licence: AZ 3074978) |
| Enumeration Date | 2022-03-14 |
| Last Update Date | 2022-04-26 |