| NPI | 1760184592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) (Licence: AR 900118788) |
| Additional Taxonomies | 347E00000X Transportation Broker |
| Enumeration Date | 2023-03-17 |
| Last Update Date | 2023-03-17 |