| NPI | 1124155080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 341600000X Ambulance (Licence: PA 06108) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: PA 144821) |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2007-08-19 |