| NPI | 1871408518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: UT 12382197-1717) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: AK 241559) |
| Enumeration Date | 2026-08-17 |
| Last Update Date | 2026-08-17 |