| NPI | 1508661521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: FL ISW23493) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: FL RPT24064) |
| Enumeration Date | 2025-02-14 |
| Last Update Date | 2026-07-31 |