| NPI | 1801634852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172A00000X Driver (Licence: MA sa4971606) |
| Additional Taxonomies | 347C00000X Private Vehicle (Licence: MA 4xzd28) |
| Enumeration Date | 2024-07-15 |
| Last Update Date | 2024-07-15 |