| NPI | 1154149771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) (Licence: TX 02039054) |
| Additional Taxonomies | 172A00000X Driver (Licence: TX 02039054) |
| Enumeration Date | 2024-10-02 |
| Last Update Date | 2024-10-04 |