| NPI | 1326578824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR RPH-0016358) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA IR-60505288) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR PI-0012054) | |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2018-01-20 |