| NPI | 1952183857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376K00000X Nurse's Aide (Licence: OH 322084360609) |
| Additional Taxonomies | 251G00000X Hospice Care, Community Based |
| 251X00000X | |
| 253Z00000X In Home Supportive Care | |
| 347C00000X Private Vehicle | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2023-10-17 |
| Last Update Date | 2023-10-17 |