| NPI | 1265927172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) (Licence: MI 5803000821) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 177F00000X Lodging | |
| 251E00000X Home Health | |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2018-06-25 |