| NPI | 1952702003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 376J00000X Homemaker (Licence: PA 26063601) |
| Additional Taxonomies | 372600000X Adult Companion (Licence: PA 26063601) |
| Enumeration Date | 2014-09-09 |
| Last Update Date | 2014-09-09 |