| NPI | 1902202377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 372600000X Adult Companion (Licence: FL 233767) |
| Additional Taxonomies | 376J00000X Homemaker (Licence: FL 233767) |
| Enumeration Date | 2014-11-13 |
| Last Update Date | 2014-11-13 |