| NPI | 1558143412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376J00000X Homemaker |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2023-10-16 |
| Last Update Date | 2023-10-16 |