| NPI | 1295039402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: MD T07045) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: MD 1750109) |
| Enumeration Date | 2011-01-03 |
| Last Update Date | 2022-09-22 |