| NPI | 1336434141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: VA 0202205860) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202205860) |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2023-08-23 |