| NPI | 1851903264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) (Licence: MS 8006822128) |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2020-09-02 |