| NPI | 1902678790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) (Licence: MI W32562219330) |
| Additional Taxonomies | 172A00000X Driver (Licence: MI w325622139330) |
| 344600000X Taxi | |
| Enumeration Date | 2023-10-25 |
| Last Update Date | 2023-10-26 |