| NPI | 1326779869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: CO PHAT.0000021) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: CO 30080943) |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2022-06-29 |