| NPI | 1073273553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician Personal Care Attendant (Licence: OH RU109623) |
| Additional Taxonomies | 3747P1801X Technician Personal Care Attendant |
| Enumeration Date | 2021-12-23 |
| Last Update Date | 2021-12-23 |