| NPI | 1366217119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) (Licence: TX SLN8734) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) (Licence: TX SLN6734) |
| Enumeration Date | 2023-11-21 |
| Last Update Date | 2023-11-21 |