| NPI | 1730368622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: NY 240101021157780) |
| Additional Taxonomies | 183700000X Pharmacy Technician |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2007-10-29 |