| NPI | 1336675966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03337968) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 06012786) |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2023-12-01 |