| NPI | 1487350781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: FL ps30485) |
| Additional Taxonomies | 1835P2201X Pharmacist, Ambulatory Care (Licence: FL PS34085) |
| Enumeration Date | 2023-02-07 |
| Last Update Date | 2023-02-07 |