| NPI | 1659035996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172A00000X Driver (Licence: NJ B50095470001842) |
| Additional Taxonomies | 172A00000X Driver |
| 342000000X Transportation Network Company | |
| 342000000X Transportation Network Company (Licence: NJ B50095470001842) | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 343900000X Non-emergency Medical Transport (VAN) (Licence: NJ B50095470001842) | |
| 347C00000X Private Vehicle (Licence: NJ B50095470001842) | |
| 347E00000X Transportation Broker | |
| 347E00000X Transportation Broker (Licence: NJ B50095470001842) | |
| Enumeration Date | 2021-10-22 |
| Last Update Date | 2021-10-22 |