| NPI | 1063869725 |
|---|---|
| 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: OH 03440320) |
| 183500000X Pharmacist (Licence: AZ S022264) | |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2022-05-12 |