| NPI | 1427668581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health (Licence: OH 4519008) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) (Licence: OH 4519008) |
| 385H00000X Respite Care (Licence: OH 4519008) | |
| 164W00000X Licensed Practical Nurse (Licence: OH 169917) | |
| Enumeration Date | 2020-08-04 |
| Last Update Date | 2021-08-20 |