| NPI | 1760290597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174200000X Meals |
| Additional Taxonomies | 171WH0202X Contractor, Home Modifications |
| 172A00000X Driver | |
| 177F00000X Lodging | |
| Enumeration Date | 2024-12-26 |
| Last Update Date | 2024-12-26 |