| NPI | 1285466268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL M452930971630) |
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: FL M452930971630) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL M452930971630) | |
| Enumeration Date | 2024-08-17 |
| Last Update Date | 2024-08-21 |