| NPI | 1679855217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 53464) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TN E00319350) |
| 183500000X Pharmacist (Licence: GA RPH033382) | |
| Enumeration Date | 2011-09-09 |
| Last Update Date | 2022-12-22 |