| NPI | 1164230710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835E0208X Pharmacist, Emergency Medicine (Licence: DC 8151219) |
| Additional Taxonomies | 1835E0208X Pharmacist, Emergency Medicine (Licence: CO PHA.0020054) |
| Enumeration Date | 2024-12-27 |
| Last Update Date | 2025-01-11 |