| NPI | 1770008914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 347E00000X Transportation Broker (Licence: FL b453544754290) |
| Additional Taxonomies | 172A00000X Driver (Licence: FL b453544754290) |
| Enumeration Date | 2017-08-09 |
| Last Update Date | 2022-07-21 |