| NPI | 1194166793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS53318) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL PSI28976) |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2015-07-23 |