| NPI | 1649881699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: MA PH236926) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH236926) |
| 183500000X Pharmacist (Licence: MI 5302415202) | |
| 183500000X Pharmacist (Licence: VT 033.0135009) | |
| 183500000X Pharmacist (Licence: NH PHCY-01545) | |
| 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MA CDTM10000083) | |
| 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MA MCS000162P) | |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2024-05-16 |