| NPI | 1316603905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: AR 927290469) |
| Enumeration Date | 2021-11-09 |
| Last Update Date | 2022-06-27 |