| NPI | 1396998605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AR P1412114) |
| Additional Taxonomies | 183700000X Pharmacy Technician |
| Enumeration Date | 2008-10-30 |
| Last Update Date | 2021-04-20 |