| NPI | 1770233074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171WH0202X Contractor, Home Modifications |
| Additional Taxonomies | 225XE0001X Occupational Therapist, Environmental Modification (Licence: NM 406106) |
| Enumeration Date | 2022-03-28 |
| Last Update Date | 2022-03-28 |