| NPI | 1063029262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care (Licence: OH 2107787) |
| Additional Taxonomies | 347C00000X Private Vehicle (Licence: OH 2107787) |
| 3747P1801X Technician, Personal Care Attendant (Licence: OH 2107787) | |
| Enumeration Date | 2020-09-30 |
| Last Update Date | 2020-09-30 |