| NPI | 1710426408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: MD 22464) |
| Additional Taxonomies | 1835C0205X Pharmacist, Critical Care (Licence: MD 22464) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: MD 22464) | |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2017-02-15 |