| NPI | 1801273495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 146N00000X Emergency Medical Technician, Basic (Licence: NJ 594522) |
| Additional Taxonomies | 341600000X Ambulance (Licence: NJ 1211081) |
| Enumeration Date | 2015-05-03 |
| Last Update Date | 2015-05-04 |