| NPI | 1992696264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: TX WWK0154) |
| Additional Taxonomies | 347C00000X Private Vehicle (Licence: TX WWK0154) |
| Enumeration Date | 2025-07-14 |
| Last Update Date | 2025-07-14 |