| NPI | 1518596709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171WH0202X Contractor Home Modifications (Licence: ND 20933) |
| Additional Taxonomies | 171W00000X Contractor (Licence: ND 20933) |
| 171WH0202X Contractor Home Modifications | |
| 224ZE0001X Occupational Therapy Assistant Environmental Modification (Licence: MT 4665) | |
| 224ZE0001X Occupational Therapy Assistant Environmental Modification (Licence: ND 1450) | |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2020-06-01 |