| NPI | 1235963448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care (Licence: OH UM622867) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) (Licence: OH UM622867) |
| Enumeration Date | 2024-08-29 |
| Last Update Date | 2024-08-29 |