| NPI | 1629342670 |
|---|---|
| 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: PA RP440122) |
| 183500000X Pharmacist (Licence: IN 26017794) | |
| 183500000X Pharmacist (Licence: NJ 28RI03036500) | |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: NJ 25MA09748100) | |
| 207R00000X Internal Medicine (Licence: PA MD456047) | |
| Enumeration Date | 2012-03-07 |
| Last Update Date | 2018-11-02 |