| NPI | 1548587082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH PN037569) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: OH PN037569) |
| 372600000X Adult Companion (Licence: OH PN037569) | |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2010-04-23 |