| NPI | 1437530276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S021336) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ I010243) |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2015-08-31 |