| NPI | 1306596879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PR 2324) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 2324) |
| Enumeration Date | 2022-03-27 |
| Last Update Date | 2022-03-27 |