| NPI | 1710508940 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: AR PD06484) |
| Additional Taxonomies | 1835P2201X Pharmacist, Ambulatory Care (Licence: AR pd6484) |
| Enumeration Date | 2020-04-28 |
| Last Update Date | 2020-04-28 |