| NPI | 1861009854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: OH 2542314) |
| Additional Taxonomies | 172A00000X Driver |
| 251E00000X Home Health | |
| 253Z00000X In Home Supportive Care | |
| 305S00000X Point of Service | |
| 343800000X Secured Medical Transport (VAN) | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 347B00000X Bus | |
| 347C00000X Private Vehicle | |
| 376J00000X Homemaker | |
| 385H00000X Respite Care | |
| Enumeration Date | 2020-09-24 |
| Last Update Date | 2021-09-28 |