| NPI | 1124843263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172A00000X Driver |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) (Licence: TX 08802306) |
| Enumeration Date | 2024-11-22 |
| Last Update Date | 2025-01-07 |