| NPI | 1184161853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 347C00000X Private Vehicle (Licence: CO 10026902) |
| Additional Taxonomies | 347C00000X Private Vehicle (Licence: CO 072630929) |
| Enumeration Date | 2017-01-19 |
| Last Update Date | 2017-01-19 |