| NPI | 1063275253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: OH 112132) |
| Enumeration Date | 2024-02-01 |
| Last Update Date | 2024-02-01 |