| NPI | 1598488504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 347C00000X Private Vehicle |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2022-09-23 |
| Last Update Date | 2022-09-28 |