| NPI | 1629712690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 374U00000X Home Health Aide |
| 376J00000X Homemaker | |
| Enumeration Date | 2022-04-25 |
| Last Update Date | 2024-10-17 |