| NPI | 1386215028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: TN 3169592) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 45231) |
| Enumeration Date | 2021-07-04 |
| Last Update Date | 2024-03-15 |