| NPI | 1508674599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172A00000X Driver (Licence: TX 51462457) |
| Additional Taxonomies | 156F00000X Technician/Technologist |
| 171W00000X Contractor | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 344600000X Taxi | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2024-12-21 |
| Last Update Date | 2024-12-21 |