| NPI | 1124384045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 347C00000X Private Vehicle (Licence: AZ atn9038) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| 347C00000X Private Vehicle (Licence: AZ apf8708) | |
| 347C00000X Private Vehicle (Licence: AZ avf9340) | |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2012-04-04 |