| NPI | 1659695096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: TN 00029481) |
| Additional Taxonomies | 171WH0202X Contractor, Home Modifications (Licence: TN 00029481) |
| Enumeration Date | 2010-03-14 |
| Last Update Date | 2010-03-14 |