| NPI | 1154135770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 347E00000X Transportation Broker (Licence: WA 001) |
| Enumeration Date | 2025-02-04 |
| Last Update Date | 2025-10-28 |