| NPI | 1104108067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171WH0202X Contractor, Home Modifications (Licence: TX H921060) |
| Additional Taxonomies | 171WH0202X Contractor, Home Modifications (Licence: TX TS921473) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2011-09-15 |