| NPI | 1700223153 |
|---|---|
| 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: PA RP446667) |
| Enumeration Date | 2013-05-24 |
| Last Update Date | 2021-06-20 |