| NPI | 1720736127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 172A00000X Driver (Licence: TN 079487198) |
| 174200000X Meals | |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2022-03-15 |
| Last Update Date | 2022-03-15 |