| NPI | 1265165039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: MD T24909) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2022-07-07 |
| Last Update Date | 2023-09-29 |