| NPI | 1033942727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: MO 17893) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: MO 2017008649) |
| Enumeration Date | 2024-08-20 |
| Last Update Date | 2024-08-20 |