| NPI | 1437452257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist Ambulatory Care (Licence: MN 118567) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 118567) |
| 1835I0206X (Licence: MN 118567) | |
| Enumeration Date | 2010-12-16 |
| Last Update Date | 2023-12-11 |