| NPI | 1851718480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146N00000X Emergency Medical Technician, Basic |
| Additional Taxonomies | 171W00000X Contractor |
| 172A00000X Driver | |
| Enumeration Date | 2014-03-20 |
| Last Update Date | 2014-03-20 |