| NPI | 1063993152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 84687) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 42733) |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2023-03-07 |