| NPI | 1831088558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) (Licence: OH VA456097) |
| Additional Taxonomies | 251E00000X Home Health (Licence: OH VA456097) |
| 347C00000X Private Vehicle (Licence: OH VA456097) | |
| Enumeration Date | 2025-06-30 |
| Last Update Date | 2025-06-30 |