| NPI | 1952041717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 341600000X Ambulance (Licence: PR 4980116) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) (Licence: PR 4980116) |
| 347C00000X Private Vehicle (Licence: PR 4980116) | |
| Enumeration Date | 2022-03-30 |
| Last Update Date | 2022-04-06 |