| NPI | 1114880440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: IA 41104) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: NE 16094) |
| 183700000X Pharmacy Technician (Licence: IA PTCB-30298586) | |
| Enumeration Date | 2025-12-04 |
| Last Update Date | 2025-12-04 |