| NPI | 1215702352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835E0208X Pharmacist, Emergency Medicine (Licence: IA 24775) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IA 24775) |
| Enumeration Date | 2023-11-20 |
| Last Update Date | 2023-11-20 |