| NPI | 1326648825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: TX 217641) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: NM PT00011253) |
| Enumeration Date | 2020-10-26 |
| Last Update Date | 2020-10-26 |