| NPI | 1831514231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AL 20542) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AL s11003) |
| Enumeration Date | 2014-02-22 |
| Last Update Date | 2019-10-02 |