NPI | 1629630488 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: MN 124294) |
Additional Taxonomies | 183500000X Pharmacist (Licence: MN 124294) |
Enumeration Date | 2019-07-02 |
Last Update Date | 2021-09-01 |