| NPI | 1720435522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: MD 23478) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DE a1-0004777) |
| Enumeration Date | 2016-05-21 |
| Last Update Date | 2016-05-21 |