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1275358806
ETHAN SHAKEEL JEFFERSON
SACRAMENTO, CA
NPI
1275358806
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-11-19
Last Update Date
2024-11-19
Business Address
ETHAN SHAKEEL JEFFERSON
2725 I ST APT 2
SACRAMENTO, CA 95816-4367
Phone number: 530-615-1615
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Mailing Address
ETHAN SHAKEEL JEFFERSON
2725 I ST APT 2
SACRAMENTO, CA 95816-4367
Phone number: 530-615-1615
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