| NPI | 1972118321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care (Licence: OH 0212023) |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: OH 0212023) |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2020-09-12 |
| Last Update Date | 2020-09-17 |