| NPI | 1346891157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: MN 123934) |
| Additional Taxonomies | 1835E0208X Pharmacist, Emergency Medicine (Licence: MN 123934) |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2023-07-21 |