| NPI | 1992731012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171W00000X Contractor (Licence: MI AS250010928) |
| Additional Taxonomies | 177F00000X Lodging (Licence: MI AS250010928) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2007-07-08 |