| NPI | 1790371953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AR PD06697) |
| Additional Taxonomies | 1835P2201X Pharmacist Ambulatory Care (Licence: AR PD06697) |
| Enumeration Date | 2020-12-11 |
| Last Update Date | 2020-12-11 |