| NPI | 1033008271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO 25322) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO 2008692) |
| Enumeration Date | 2025-07-01 |
| Last Update Date | 2025-08-31 |