| NPI | 1215710686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835C0205X Pharmacist Critical Care (Licence: NY 069442) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 68796) |
| Enumeration Date | 2023-08-17 |
| Last Update Date | 2023-08-17 |