| NPI | 1487087920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 372600000X Adult Companion (Licence: FL 233119) |
| Additional Taxonomies | 376J00000X Homemaker (Licence: FL 233119) |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2013-08-20 |