| NPI | 1497280077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03232944) |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2022-06-14 |