| NPI | 1851836134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: PA OT022383) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NJ 28RI03711400) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-12-22 |
| Last Update Date | 2023-05-23 |