| NPI | 1265115547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: ID CT66258) |
| 246RP1900X Technician, Pathology, Phlebotomy (Licence: ID 001102032001) | |
| Enumeration Date | 2023-08-11 |
| Last Update Date | 2023-08-11 |