| NPI | 1912319682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE A1-0004950) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA PI113632) |
| 183500000X Pharmacist (Licence: PA RP448608) | |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2023-08-22 |