| NPI | 1144771528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI2326000) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA RP041496R) |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2021-11-30 |