| NPI | 1275234643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 347E00000X Transportation Broker |
| Additional Taxonomies | 171400000X Health & Wellness Coach |
| 171W00000X Contractor | |
| 172A00000X Driver | |
| 174H00000X Health Educator | |
| 332000000X MilitaryU.S. Coast Guard Pharmacy | |
| 332100000X Department of Veterans Affairs (VA) Pharmacy | |
| 333600000X Pharmacy | |
| Enumeration Date | 2023-03-13 |
| Last Update Date | 2023-03-13 |