| NPI | 1043699325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 55105) |
| Additional Taxonomies | 171W00000X Contractor |
| 174H00000X Health Educator | |
| 246ZB0500X Specialist/Technologist, Other, Biochemist | |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2021-10-08 |