| NPI | 1235478751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: GA PHTC003567) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: GA 500107010023466) |
| Enumeration Date | 2013-02-04 |
| Last Update Date | 2013-02-04 |