| NPI | 1982534749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172A00000X Driver |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| 347E00000X Transportation Broker | |
| Enumeration Date | 2026-05-21 |
| Last Update Date | 2026-06-10 |