| NPI | 1528695301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) (Licence: AZ D08570925) |
| Additional Taxonomies | 172A00000X Driver (Licence: AZ D08570925) |
| 372500000X Chore Provider | |
| 374U00000X Home Health Aide | |
| 376J00000X Homemaker | |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2020-03-24 |