| NPI | 1790251338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171WH0202X Contractor Home Modifications (Licence: VA 2705118405) |
| Additional Taxonomies | 171W00000X Contractor (Licence: VA 2705118405) |
| Enumeration Date | 2018-10-22 |
| Last Update Date | 2018-10-22 |