| NPI | 1972285443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343800000X Secured Medical Transport (VAN) (Licence: TX 47687305) |
| Additional Taxonomies | 172A00000X Driver (Licence: TX 47687305) |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2023-08-03 |
| Last Update Date | 2023-08-22 |