| NPI | 1740098375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 385HR2050X Respite Care, Respite Care Camp |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2024-12-30 |
| Last Update Date | 2024-12-30 |