NPI | 1467040915 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1835P2201X Pharmacist Ambulatory Care (Licence: CA 82382) |
Additional Taxonomies | 183500000X Pharmacist (Licence: CA 82382) |
1835P1200X Pharmacist Pharmacotherapy (Licence: CA 82382) | |
Enumeration Date | 2021-01-08 |
Last Update Date | 2022-05-17 |