| NPI | 1679784409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: AL 7701) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AL 7701) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2007-07-08 |