| NPI | 1811446966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA A189298) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 72089) |
| Enumeration Date | 2016-09-30 |
| Last Update Date | 2024-02-14 |