| NPI | 1588375265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: NY 001761-01) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: NJ 28RW04343200) |
| Enumeration Date | 2022-12-13 |
| Last Update Date | 2022-12-13 |