| NPI | 1073295234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835G0303X Pharmacist, Geriatric (Licence: OR 9476) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: OR 48691) |
| 1835G0303X Pharmacist, Geriatric (Licence: TX 72114) | |
| Enumeration Date | 2023-08-07 |
| Last Update Date | 2023-08-07 |