| NPI | 1316454283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 172A00000X Driver (Licence: OH sm821261) |
| 1744G0900X Specialist, Graphics Designer | |
| 251V00000X Voluntary or Charitable | |
| 344600000X Taxi | |
| Enumeration Date | 2018-01-02 |
| Last Update Date | 2024-02-17 |