| NPI | 1629485982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) (Licence: WI 346WFF) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: WI 346WFF) |
| Enumeration Date | 2014-07-18 |
| Last Update Date | 2014-07-18 |