| NPI | 1285428912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) (Licence: MI 5802020115) |
| Additional Taxonomies | 174200000X Meals |
| 177F00000X Lodging | |
| 3336M0002X Pharmacy, Mail Order Pharmacy | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2025-04-07 |
| Last Update Date | 2025-04-30 |