| NPI | 1225585862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: CA 136210) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2022-07-21 |