| NPI | 1235837329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X (Licence: OH 2567968) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care (Licence: OH 2567968) |
| Enumeration Date | 2023-02-20 |
| Last Update Date | 2023-02-21 |