| NPI | 1518662022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 172A00000X Driver |
| 172A00000X Driver | |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2023-05-10 |