| NPI | 1972227130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 246RP1900X Technician, Pathology, Phlebotomy |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2022-09-30 |
| Last Update Date | 2023-08-02 |