| NPI | 1518389634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) (Licence: CA 201335710379) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) (Licence: CA 46 44088766) |
| Enumeration Date | 2014-01-08 |
| Last Update Date | 2014-01-08 |