| NPI | 1790592806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: LA PST.023580) |
| Additional Taxonomies | 1835P2201X Pharmacist, Ambulatory Care (Licence: FL PS57973) |
| Enumeration Date | 2024-12-12 |
| Last Update Date | 2024-12-12 |