| NPI | 1295431104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172A00000X Driver |
| Additional Taxonomies | 342000000X Transportation Network Company |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 347E00000X Transportation Broker | |
| Enumeration Date | 2023-02-02 |
| Last Update Date | 2023-02-02 |