| NPI | 1699249144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH033423) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 22254) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: AL S12398) | |
| Enumeration Date | 2019-01-17 |
| Last Update Date | 2022-12-23 |