| NPI | 1295169498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 26043) |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: DC 8987) |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2013-08-25 |
| Last Update Date | 2019-07-31 |