| NPI | 1376982140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: OR CPT-0005756) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: CA 105423) |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2013-06-14 |