| NPI | 1679075899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO 0020001) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: CO 0020001) |
| 1835P2201X Pharmacist, Ambulatory Care (Licence: CO 0020001) | |
| Enumeration Date | 2018-03-03 |
| Last Update Date | 2018-03-17 |