| NPI | 1053781815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: OH 0500686) |
| Enumeration Date | 2015-10-05 |
| Last Update Date | 2025-01-13 |