| NPI | 1689243859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS62994) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL PSI37606) |
| Enumeration Date | 2021-06-22 |
| Last Update Date | 2021-12-16 |