| NPI | 1396551842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 171W00000X Contractor |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 347E00000X Transportation Broker | |
| Enumeration Date | 2024-12-09 |
| Last Update Date | 2024-12-09 |