| NPI | 1396485975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172A00000X Driver |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant |
| 343800000X Secured Medical Transport (VAN) | |
| Enumeration Date | 2022-03-31 |
| Last Update Date | 2022-03-31 |