| NPI | 1083197537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) (Licence: IA 734zz0755) |
| Additional Taxonomies | 344600000X Taxi (Licence: IA 734ZZ0755) |
| Enumeration Date | 2018-09-11 |
| Last Update Date | 2018-09-11 |