| NPI | 1548708555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: CA 36270) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: CA 36270) |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2017-02-09 |