| NPI | 1558618660 |
|---|---|
| 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: MN 120990) |
| 183500000X Pharmacist (Licence: MA PH234400) | |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2021-03-31 |