| NPI | 1831698588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PR 6433) |
| Enumeration Date | 2018-02-08 |
| Last Update Date | 2022-04-18 |