| NPI | 1003184417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS E09972) |
| Additional Taxonomies | 1835P2201X Pharmacist Ambulatory Care (Licence: MS E-09972) |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2023-03-23 |