| NPI | 1821986811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: IN 67043852A) |
| Enumeration Date | 2025-06-26 |
| Last Update Date | 2025-10-05 |