| NPI | 1134707565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183700000X Pharmacy Technician |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2025-12-31 |