| NPI | 1639053630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician Personal Care Attendant |
| Additional Taxonomies | 172A00000X Driver (Licence: OH TM257031) |
| 343900000X Non-emergency Medical Transport (VAN) (Licence: OH TM257031) | |
| 376J00000X Homemaker | |
| Enumeration Date | 2025-08-04 |
| Last Update Date | 2025-08-04 |