| NPI | 1679020754 |
|---|---|
| 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: AZ S022152) |
| Enumeration Date | 2016-09-06 |
| Last Update Date | 2022-03-22 |