| NPI | 1659085447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 163WH0500X Registered Nurse, Hemodialysis (Licence: CA 95102355) |
| Enumeration Date | 2023-01-06 |
| Last Update Date | 2023-01-06 |