| NPI | 1295349710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: MN 121848) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: MN 121848) |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2020-09-02 |