| NPI | 1245896190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: PR 10312) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: PR 30036828) |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2019-05-16 |