| NPI | 1679052146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: IN 26027954A) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 25226) |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2023-09-06 |