| NPI | 1184316069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: PA RP458486) |
| Additional Taxonomies | 1835P2201X Pharmacist, Ambulatory Care (Licence: NJ 28RI04314300) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-05-22 |
| Last Update Date | 2024-10-23 |