| NPI | 1447793625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist Ambulatory Care (Licence: PA RP451211) |
| Additional Taxonomies | 1835P2201X Pharmacist Ambulatory Care (Licence: MA PH236079) |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2016-11-21 |