| NPI | 1114207677 |
|---|---|
| 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: FL PS 45334) |
| Enumeration Date | 2011-08-27 |
| Last Update Date | 2022-03-23 |