| NPI | 1649555632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: TX 50187) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 50187) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: TX 50187) | |
| Enumeration Date | 2011-10-21 |
| Last Update Date | 2020-06-08 |