| NPI | 1154885978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 344600000X Taxi (Licence: FL P241-509-77-214-0) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) (Licence: FL P241-509-77-214-0) |
| Enumeration Date | 2019-01-25 |
| Last Update Date | 2019-01-25 |