| NPI | 1073082863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: 30061947) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: FL RPT75741) |
| Enumeration Date | 2018-11-21 |
| Last Update Date | 2018-11-21 |