| NPI | 1023402526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2016019833) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AL S10704) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2023-05-04 |