| NPI | 1548034473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 347C00000X Private Vehicle |
| Additional Taxonomies | 172A00000X Driver |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 261QA0600X Clinic/Center, Adult Day Care | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2023-11-10 |
| Last Update Date | 2023-11-10 |