| NPI | 1831929918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: NC 87563) |
| Additional Taxonomies | 171WH0202X Contractor Home Modifications (Licence: NC 87563) |
| Enumeration Date | 2024-08-05 |
| Last Update Date | 2024-11-19 |