| NPI | 1164190344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 347C00000X Private Vehicle (Licence: OH HPW8385) |
| Additional Taxonomies | 172A00000X Driver (Licence: OH HPW8385) |
| 253Z00000X In Home Supportive Care (Licence: OH HPW8385) | |
| 3747P1801X Technician, Personal Care Attendant (Licence: OH HPW8385) | |
| 376J00000X Homemaker (Licence: OH HPW8385) | |
| Enumeration Date | 2021-09-01 |
| Last Update Date | 2021-09-01 |