| NPI | 1508636697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835C0205X Pharmacist, Critical Care (Licence: TX 55480) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: TX 220434) |
| 183500000X Pharmacist (Licence: TX 55480) | |
| Enumeration Date | 2024-01-08 |
| Last Update Date | 2024-01-08 |