| NPI | 1386192383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 341600000X Ambulance (Licence: GA 059119434) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) (Licence: GA 059119434) |
| Enumeration Date | 2016-09-19 |
| Last Update Date | 2016-09-19 |