| NPI | 1952848970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 347C00000X Private Vehicle (Licence: VA T66824582) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) (Licence: VA T66824582) |
| Enumeration Date | 2017-01-28 |
| Last Update Date | 2017-01-28 |