| NPI | 1730585605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: PR 9851) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: FL 80265) |
| Enumeration Date | 2014-11-05 |
| Last Update Date | 2020-02-23 |