| NPI | 1679842132 |
|---|---|
| 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: FL ps40966) |
| Enumeration Date | 2011-12-29 |
| Last Update Date | 2025-05-20 |