| NPI | 1538965587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3416L0300X Ambulance, Land Transport |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic |
| Enumeration Date | 2025-02-20 |
| Last Update Date | 2025-02-20 |