| NPI | 1043864218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: MT 6154562) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MT PHA-PHA-LIC-63005) |
| Enumeration Date | 2019-07-26 |
| Last Update Date | 2024-04-18 |