| NPI | 1720769037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: CO PHA.0024992) |
| Additional Taxonomies | 1835P2201X Pharmacist, Ambulatory Care (Licence: AL 23140) |
| 1835P2201X Pharmacist, Ambulatory Care (Licence: PA RP457697) | |
| Enumeration Date | 2023-07-28 |
| Last Update Date | 2025-03-12 |