| NPI | 1922676816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP450187) |
| 183500000X Pharmacist (Licence: NJ 28RI03748100) | |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2024-06-19 |