| NPI | 1972231371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA RP457018) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP457018) |
| Enumeration Date | 2022-08-12 |
| Last Update Date | 2022-08-12 |