NPI | 1164944658 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1835P0200X Pharmacist, Pediatrics (Licence: OK 17518) |
Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: OK 17518) |
1835P2201X Pharmacist, Ambulatory Care (Licence: OK 17518) | |
Enumeration Date | 2017-07-17 |
Last Update Date | 2017-07-17 |