| NPI | 1609268739 |
|---|---|
| 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: NY 059367) |
| Enumeration Date | 2015-02-26 |
| Last Update Date | 2021-05-05 |