| NPI | 1972961001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) (Licence: MN 86708300035) |
| Enumeration Date | 2016-02-03 |
| Last Update Date | 2019-03-06 |