| NPI | 1750265237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: OR RPH-0020524) |
| Additional Taxonomies | 1835P2201X Pharmacist, Ambulatory Care (Licence: WA PH61563213) |
| Enumeration Date | 2025-08-05 |
| Last Update Date | 2025-08-05 |