| NPI | 1477651289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5151013993) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302031866) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: MI 5302031866) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2019-05-23 |