| NPI | 1144978511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS65325) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 37533) |
| Enumeration Date | 2022-03-15 |
| Last Update Date | 2022-12-10 |