| NPI | 1831698240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171WH0202X Contractor, Home Modifications (Licence: PA PA097368) |
| Additional Taxonomies | 171WV0202X Contractor, Vehicle Modifications |
| Enumeration Date | 2018-02-12 |
| Last Update Date | 2018-02-12 |