| NPI | 1255035549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2023-03-29 |
| Last Update Date | 2026-07-16 |