| NPI | 1760075980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 347E00000X Transportation Broker (Licence: TN 135125512) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2021-02-18 |
| Last Update Date | 2021-02-18 |