| NPI | 1720544240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) (Licence: LA 006674536) |
| Additional Taxonomies | 343800000X Secured Medical Transport (VAN) (Licence: LA 006674536) |
| 347C00000X Private Vehicle (Licence: LA 006674536) | |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2019-02-20 |