| NPI | 1750749511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 061378) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 091827) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA PI58724) | |
| Enumeration Date | 2016-02-08 |
| Last Update Date | 2016-02-08 |