| NPI | 1245832781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2020-11-10 |
| Last Update Date | 2020-11-10 |