| NPI | 1699381277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376J00000X Homemaker (Licence: OH 2305482) |
| Additional Taxonomies | 251E00000X Home Health (Licence: OH 2305482) |
| Enumeration Date | 2020-09-19 |
| Last Update Date | 2020-09-19 |