| NPI | 1417550260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care (Licence: OH 3124757) |
| Additional Taxonomies | 347C00000X Private Vehicle (Licence: OH 3124757) |
| 374U00000X Home Health Aide (Licence: OH 3124757) | |
| Enumeration Date | 2020-11-16 |
| Last Update Date | 2020-11-16 |