| NPI | 1356732853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 77513) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2013034710) |
| Enumeration Date | 2015-02-05 |
| Last Update Date | 2018-03-17 |