| NPI | 1356708853 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) | 
| Additional Taxonomies | 344600000X Taxi | 
| 347C00000X Private Vehicle | |
| Enumeration Date | 2016-01-28 | 
| Last Update Date | 2016-01-28 |