| NPI | 1053717215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WV RP0008208) |
| Enumeration Date | 2014-11-14 |
| Last Update Date | 2024-08-01 |