| NPI | 1174838395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: UT 6151352) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: UT 345828-8911) |
| 183500000X Pharmacist (Licence: UT 345828-1701) | |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: UT 345828-1701) | |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: AZ S018071) | |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2022-10-25 |