| NPI | 1760721468 |
|---|---|
| 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: CA 68034) |
| Enumeration Date | 2013-01-31 |
| Last Update Date | 2017-05-03 |