| NPI | 1306989538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: FL PH30259) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL ps29194) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2024-05-09 |