| NPI | 1831494681 |
|---|---|
| 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: NY 0551174) |
| Enumeration Date | 2011-01-25 |
| Last Update Date | 2024-07-04 |