NPI | 1104201847 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: PA RP449639) |
Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP449639) |
Enumeration Date | 2015-07-23 |
Last Update Date | 2024-02-15 |