| NPI | 1558976019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care (Licence: OH 3121026) |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant (Licence: OH 3121026) |
| Enumeration Date | 2020-09-11 |
| Last Update Date | 2020-09-11 |