| NPI | 1386333722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: UT 8862763-1701) |
| Additional Taxonomies | 1835P2201X Pharmacist, Ambulatory Care (Licence: WA PH61441586) |
| 1835P2201X Pharmacist, Ambulatory Care (Licence: OR RPH-0019012) | |
| Enumeration Date | 2023-05-02 |
| Last Update Date | 2025-12-11 |