| NPI | 1396558953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343800000X Secured Medical Transport (VAN) (Licence: GA OCC040511) |
| Additional Taxonomies | 172A00000X Driver (Licence: GA OCC040511) |
| 343900000X Non-emergency Medical Transport (VAN) (Licence: GA OCC040511) | |
| Enumeration Date | 2025-01-28 |
| Last Update Date | 2025-02-06 |