| NPI | 1417504416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171WH0202X Contractor Home Modifications |
| Additional Taxonomies | 171WV0202X Contractor Vehicle Modifications |
| Enumeration Date | 2019-08-23 |
| Last Update Date | 2019-08-23 |