| NPI | 1366192882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ I026653) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: AZ T073006) |
| Enumeration Date | 2022-03-27 |
| Last Update Date | 2026-08-04 |