NPI | 1194280404 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 172A00000X Driver (Licence: LA 006138892) |
Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) (Licence: LA 006138892) |
Enumeration Date | 2019-01-31 |
Last Update Date | 2019-10-09 |