NPI | 1568943470 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1835P2201X Pharmacist Ambulatory Care (Licence: WY 3134) |
Additional Taxonomies | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: WY 3134) |
Enumeration Date | 2018-08-28 |
Last Update Date | 2018-08-28 |