| NPI | 1710755996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 347C00000X Private Vehicle (Licence: OH RN582834) |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: OH RN582834) |
| 343900000X Non-emergency Medical Transport (VAN) (Licence: OH RN582834) | |
| 3747P1801X Technician, Personal Care Attendant (Licence: OH RN582834) | |
| Enumeration Date | 2023-12-18 |
| Last Update Date | 2023-12-19 |