| NPI | 1982163465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) (Licence: CA 81-4404308) |
| Additional Taxonomies | 347E00000X Transportation Broker (Licence: CA 81-4404308) |
| Enumeration Date | 2019-03-14 |
| Last Update Date | 2019-04-09 |