NPI | 1992067011 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH 159087) |
Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: OH RN.482536) |
171W00000X Contractor | |
385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
Enumeration Date | 2012-06-14 |
Last Update Date | 2024-07-12 |