| NPI | 1528932001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: VA 0202213864) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DC PH100000352) |
| 183500000X Pharmacist (Licence: AZ S014360) | |
| Enumeration Date | 2025-09-30 |
| Last Update Date | 2025-09-30 |