| NPI | 1508878539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: DC 1401-0452-0763-960) |
| Additional Taxonomies | 136A00000X Dietetic Technician, Registered |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2007-07-13 |