| NPI | 1760094643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 310505) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 60689) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC ZEHD-P1A7SE) | |
| Enumeration Date | 2020-08-20 |
| Last Update Date | 2022-05-26 |