| NPI | 1679210694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT PCI.0010039) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: MA PTT15131) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA PI167939) | |
| Enumeration Date | 2022-05-20 |
| Last Update Date | 2022-05-20 |