| NPI | 1407459373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician Personal Care Attendant (Licence: OH 103718675499) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care (Licence: OH 103718675499) |
| 376J00000X Homemaker (Licence: OH 103718675499) | |
| 385H00000X Respite Care (Licence: OH 103718675499) | |
| Enumeration Date | 2020-11-20 |
| Last Update Date | 2020-11-20 |