| NPI | 1306537485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: MI 5303045683) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2023-05-18 |
| Last Update Date | 2023-05-18 |