| NPI | 1306577507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: AR PD16175) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AR PD16175) |
| Enumeration Date | 2022-06-20 |
| Last Update Date | 2023-11-16 |