NPI | 1639805518 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: MI 5302415284) |
Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302415284) |
Enumeration Date | 2022-07-25 |
Last Update Date | 2024-11-01 |