| NPI | 1962688622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 171WH0202X Contractor, Home Modifications |
| 172A00000X Driver | |
| 247200000X Technician, Other | |
| 374700000X Technician | |
| 376J00000X Homemaker | |
| Enumeration Date | 2008-01-11 |
| Last Update Date | 2008-01-11 |