| NPI | 1881301406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 172A00000X Driver (Licence: TX 10441788) |
| Enumeration Date | 2022-11-02 |
| Last Update Date | 2022-11-03 |