| NPI | 1497115778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 251E00000X Home Health (Licence: MA s09581593) |
| 172A00000X Driver (Licence: MA s09581593) | |
| 347C00000X Private Vehicle (Licence: MA s09581593) | |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: MA s09581593) | |
| 261QH0100X Clinic/Center, Health Services (Licence: MA s09581593) | |
| 261QM2800X Clinic/Center, Methadone Clinic (Licence: MA s09581593) | |
| 347E00000X Transportation Broker | |
| Enumeration Date | 2016-03-01 |
| Last Update Date | 2017-01-12 |