| NPI | 1720833957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS64779) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH239651) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: FL 3168057) | |
| Enumeration Date | 2024-04-22 |
| Last Update Date | 2024-04-22 |