| NPI | 1720594799 |
|---|---|
| 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: IA 22740) |
| 183500000X Pharmacist (Licence: MN 123030) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: WI 102475-851) | |
| Enumeration Date | 2017-12-28 |
| Last Update Date | 2026-06-14 |