| NPI | 1932519980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) (Licence: LA 004530995) |
| Additional Taxonomies | 172A00000X Driver (Licence: LA 004530995) |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2014-04-29 |