| NPI | 1922830975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 172A00000X Driver |
| 175T00000X Peer Specialist | |
| 343800000X Secured Medical Transport (VAN) | |
| Enumeration Date | 2024-08-19 |
| Last Update Date | 2024-12-26 |