| NPI | 1639572845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: TX 321919) |
| 344600000X Taxi | |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2023-06-23 |