| NPI | 1124756119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 22682) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: NC 22682) |
| Enumeration Date | 2022-08-09 |
| Last Update Date | 2022-08-31 |