| NPI | 1750635082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) (Licence: TX 08418502) |
| Additional Taxonomies | 341600000X Ambulance (Licence: TX 08418502) |
| Enumeration Date | 2012-11-08 |
| Last Update Date | 2012-11-08 |