| NPI | 1629360888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 0000039733) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL PSI27646) |
| Enumeration Date | 2011-05-06 |
| Last Update Date | 2015-09-08 |