| NPI | 1407444821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care (Licence: OH 7718762) |
| Additional Taxonomies | 347C00000X Private Vehicle (Licence: OH rv683724) |
| 3747P1801X Technician, Personal Care Attendant | |
| 376J00000X Homemaker | |
| Enumeration Date | 2021-01-03 |
| Last Update Date | 2021-01-03 |