NPI | 1780451823 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 172V00000X Community Health Worker (Licence: MO 15794) |
Additional Taxonomies | 183700000X Pharmacy Technician (Licence: MO 2014043120) |
Enumeration Date | 2023-12-08 |
Last Update Date | 2023-12-08 |