Individual
BONIFACE NINGABA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
83 PENN AVE APT 1, WORCESTER, MA 01604-4288
(774) 204-5551
Mailing address
83 PENN AVE APT 1, WORCESTER, MA 01604-4288
(774) 204-5551
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
S82667610
MA
Other
Enumeration date
07/17/2023
Last updated
07/17/2023
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