| NPI | 1922672443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: WA VA61519543) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: CA TCH175135) |
| Enumeration Date | 2021-05-19 |
| Last Update Date | 2025-08-05 |