| NPI | 1295266989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service |
| 310400000X Assisted Living Facility | |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2021-03-22 |