| NPI | 1336839182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343800000X Secured Medical Transport (VAN) (Licence: TX 39665505) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2023-05-15 |
| Last Update Date | 2025-07-29 |