| NPI | 1679035323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: VA 0202218298) |
| Additional Taxonomies | 1835P2201X Pharmacist, Ambulatory Care (Licence: CT PCT.0015418) |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2025-02-18 |