| NPI | 1780365429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376J00000X Homemaker |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| 385H00000X Respite Care | |
| Enumeration Date | 2023-07-26 |
| Last Update Date | 2023-07-26 |