| NPI | 1578287942 |
|---|---|
| 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: FL PH26586) |
| Enumeration Date | 2022-09-29 |
| Last Update Date | 2025-03-31 |