| NPI | 1245491828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: CA 591607) |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2008-06-20 |