| NPI | 1083017420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: CA 105415) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: AZ T024683) |
| 183700000X Pharmacy Technician (Licence: CA 520107010104736) | |
| Enumeration Date | 2014-09-30 |
| Last Update Date | 2014-09-30 |