| NPI | 1275806796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: MA PT8780) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: CA TCH86537) |
| Enumeration Date | 2012-02-14 |
| Last Update Date | 2012-02-14 |