NPI | 1942802574 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 376J00000X Homemaker (Licence: OH 4810171) |
Additional Taxonomies | 376J00000X Homemaker |
251S00000X Community/Behavioral Health | |
Enumeration Date | 2020-11-09 |
Last Update Date | 2023-01-17 |