| NPI | 1861904278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 66528) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO 0002006763) |
| Enumeration Date | 2017-10-26 |
| Last Update Date | 2024-12-07 |