| NPI | 1871175562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376J00000X Homemaker |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: OH 01-8523) |
| 172A00000X Driver | |
| 251X00000X | |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2021-04-22 |
| Last Update Date | 2023-09-12 |