| NPI | 1316241631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: OH 376J00000X) |
| Additional Taxonomies | 376J00000X Homemaker (Licence: OH 376K00000X) |
| 376K00000X Nurse's Aide | |
| Enumeration Date | 2010-12-29 |
| Last Update Date | 2010-12-29 |