| NPI | 1013788652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 6609276) |
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: PR 6609276) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PR 6609276) | |
| Enumeration Date | 2024-01-11 |
| Last Update Date | 2024-01-25 |