| NPI | 1992055925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) (Licence: WI 37-1659913) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: WI 146l00000x) |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2014-01-03 |