| NPI | 1609498971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: MA PT16275) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: NH CPHT-124817) |
| 183700000X Pharmacy Technician (Licence: RI PH202471) | |
| Enumeration Date | 2020-05-10 |
| Last Update Date | 2021-12-09 |