| NPI | 1295280618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) (Licence: OH RT188673) |
| Additional Taxonomies | 347C00000X Private Vehicle (Licence: OH RT188673) |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2016-08-16 |