| NPI | 1780934299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: FL rpt36741) |
| Additional Taxonomies | 172A00000X Driver (Licence: FL 201253779) |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2012-09-12 |