| NPI | 1780811836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 341600000X Ambulance |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: PR 1635) |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2009-06-16 |