| NPI | 1659062347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) (Licence: CA D4215777) |
| Additional Taxonomies | 172A00000X Driver (Licence: CA D4215777) |
| Enumeration Date | 2023-05-15 |
| Last Update Date | 2023-05-16 |