| NPI | 1114772514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health (Licence: OH DD00273764) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 372600000X Adult Companion | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2024-04-19 |
| Last Update Date | 2024-04-19 |