| NPI | 1447632120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: OH ru026801) |
| Additional Taxonomies | 172A00000X Driver (Licence: OH Ru026801) |
| 376J00000X Homemaker (Licence: OH Ru026801) | |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2025-02-28 |