| NPI | 1720353642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) (Licence: GA 45-4325039) |
| Additional Taxonomies | 3416L0300X Ambulance Land Transport (Licence: GA 45-4325039) |
| 146M00000X Emergency Medical Technician, Intermediate (Licence: GA 45-4325039) | |
| Enumeration Date | 2012-03-09 |
| Last Update Date | 2012-03-09 |