| NPI | 1366808149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171WH0202X Contractor, Home Modifications (Licence: VA 2705107988) |
| Additional Taxonomies | 171WV0202X Contractor, Vehicle Modifications (Licence: VA 2705107988) |
| Enumeration Date | 2016-01-08 |
| Last Update Date | 2016-01-08 |