| NPI | 1336828532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: MI 5302414462) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302414462) |
| 183500000X Pharmacist (Licence: IN 26030345A) | |
| Enumeration Date | 2023-07-14 |
| Last Update Date | 2024-08-04 |