| NPI | 1770811184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) (Licence: CA b5811654) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 261QC1500X Clinic/Center, Community Health | |
| Enumeration Date | 2009-11-23 |
| Last Update Date | 2025-10-06 |