| NPI | 1710537832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) (Licence: TN Txd718) |
| Additional Taxonomies | 347C00000X Private Vehicle (Licence: VA 100037766) |
| Enumeration Date | 2019-09-19 |
| Last Update Date | 2025-04-03 |