| NPI | 1912730953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) (Licence: NJ K92202257409922) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 3747A0650X Technician Attendant Care Provider | |
| 347C00000X Private Vehicle (Licence: NJ K92202257409922) | |
| Enumeration Date | 2024-08-23 |
| Last Update Date | 2024-08-23 |