| NPI | 1982077020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171WH0202X Contractor Home Modifications (Licence: CO AEC1409) |
| Additional Taxonomies | 171WH0202X Contractor Home Modifications (Licence: CO GCC5123018) |
| Enumeration Date | 2015-11-12 |
| Last Update Date | 2015-11-12 |