| NPI | 1265698229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care (Licence: MN 253Z00000X) |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2012-02-07 |