| NPI | 1417213877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD ps43909) |
| 183500000X Pharmacist (Licence: FL ps43909) | |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2024-07-09 |