NPI | 1982058020 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171WH0202X Contractor, Home Modifications (Licence: OH G02501) |
Additional Taxonomies | 171WH0202X Contractor, Home Modifications (Licence: OH HIC-L00299) |
Enumeration Date | 2016-04-14 |
Last Update Date | 2016-04-14 |