| NPI | 1932816899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: OR CPT-0015031) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: WA VB-61354257) |
| Enumeration Date | 2022-11-01 |
| Last Update Date | 2024-03-14 |