| NPI | 1306393236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: OH 400656670807) |
| Additional Taxonomies | 376J00000X Homemaker |
| 376K00000X Nurse's Aide | |
| Enumeration Date | 2016-09-08 |
| Last Update Date | 2016-09-08 |