| NPI | 1730056169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376J00000X Homemaker (Licence: OH SL639241) |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant (Licence: OH SL639241) |
| Enumeration Date | 2025-10-21 |
| Last Update Date | 2025-10-21 |