| NPI | 1487639084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS38239) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA 26276) |
| 1835P2201X Pharmacist, Ambulatory Care (Licence: FL PS38239) | |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2023-04-17 |