| NPI | 1194594275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376J00000X Homemaker (Licence: OH 73554462) |
| Additional Taxonomies | 172A00000X Driver (Licence: OH 73554462) |
| 253Z00000X In Home Supportive Care (Licence: OH 73554462) | |
| 3747P1801X Technician, Personal Care Attendant (Licence: OH 73554462) | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child (Licence: OH 73554462) | |
| Enumeration Date | 2023-12-29 |
| Last Update Date | 2023-12-29 |