| NPI | 1235475229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AL 17425) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: AL 9701068) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: AL 9579) | |
| Enumeration Date | 2012-12-18 |
| Last Update Date | 2020-11-25 |