| NPI | 1568051886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: 297540) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: TX 759564) |
| Enumeration Date | 2021-01-12 |
| Last Update Date | 2021-01-12 |