| NPI | 1568243855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 172A00000X Driver (Licence: CA 8GQE116) |
| Enumeration Date | 2023-10-11 |
| Last Update Date | 2023-10-27 |