| NPI | 1437802857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: NC 27085) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CT PCT.0014651) |
| Enumeration Date | 2022-01-27 |
| Last Update Date | 2022-01-27 |