| NPI | 1578329108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 385H00000X Respite Care (Licence: OH APS.004287) |
| Additional Taxonomies | 385H00000X Respite Care (Licence: OH FPS.000107) |
| Enumeration Date | 2024-02-21 |
| Last Update Date | 2024-02-21 |