| NPI | 1508628777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172A00000X Driver (Licence: MS 243944436) |
| Additional Taxonomies | 343800000X Secured Medical Transport (VAN) (Licence: MS 243944436) |
| 343900000X Non-emergency Medical Transport (VAN) (Licence: MS 243944436) | |
| Enumeration Date | 2024-01-24 |
| Last Update Date | 2024-02-22 |