| NPI | 1568137487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 172A00000X Driver |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2021-08-12 |
| Last Update Date | 2021-08-12 |