| NPI | 1972308351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: OH SN498611) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: OH SN498611) |
| 172A00000X Driver (Licence: OH SN498611) | |
| 372500000X Chore Provider (Licence: OH SN498611) | |
| 372600000X Adult Companion (Licence: OH SN498611) | |
| 3747A0650X Technician, Attendant Care Provider (Licence: OH SN498611) | |
| Enumeration Date | 2025-02-18 |
| Last Update Date | 2025-02-18 |