| NPI | 1366096943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343800000X Secured Medical Transport (VAN) (Licence: TX 42674915) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2023-08-30 |