| NPI | 1649663329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: AZ S025192) |
| Additional Taxonomies | 1835P2201X Pharmacist, Ambulatory Care (Licence: GA RPH029713) |
| 183500000X Pharmacist (Licence: CT PCT.0012000) | |
| Enumeration Date | 2015-03-05 |
| Last Update Date | 2024-02-09 |