| NPI | 1487041851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: MS 07739) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: TX 220770) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2015-04-22 |