| NPI | 1629433420 |
|---|---|
| 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: CA 74142) |
| Enumeration Date | 2015-12-21 |
| Last Update Date | 2025-05-01 |