| NPI | 1851823959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171WH0202X Contractor, Home Modifications |
| Additional Taxonomies | 171WV0202X Contractor, Vehicle Modifications |
| 171W00000X Contractor | |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2022-07-21 |