| NPI | 1194219634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ID P8033) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: ID P8033) |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2022-11-09 |