| NPI | 1588281588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 29617) |
| Additional Taxonomies | 1835P2201X Pharmacist, Ambulatory Care (Licence: NC 29617) |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2023-03-31 |