| NPI | 1750873311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: MD 27993) |
| Additional Taxonomies | 1835P2201X Pharmacist, Ambulatory Care (Licence: AZ S023006) |
| Enumeration Date | 2018-05-30 |
| Last Update Date | 2023-12-22 |