| NPI | 1457953317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health (Licence: OH 1830102) |
| Additional Taxonomies | 172A00000X Driver (Licence: OH 1830102) |
| 374U00000X Home Health Aide (Licence: OH 1830102) | |
| Enumeration Date | 2020-11-14 |
| Last Update Date | 2020-11-14 |