| NPI | 1902671159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3416L0300X Ambulance, Land Transport (Licence: NJ 2300117) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) (Licence: NJ 2300117) |
| Enumeration Date | 2023-11-17 |
| Last Update Date | 2023-11-17 |