| NPI | 1932562170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 018547) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 45017806A) |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2018-03-17 |