| NPI | 1093391252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171WH0202X Contractor, Home Modifications |
| Additional Taxonomies | 171WV0202X Contractor, Vehicle Modifications |
| 374700000X Technician | |
| Enumeration Date | 2021-03-19 |
| Last Update Date | 2021-03-19 |