| NPI | 1578150843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: AL S13912) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: AL T55300) |
| Enumeration Date | 2020-12-21 |
| Last Update Date | 2023-05-03 |