| NPI | 1801163993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835C0205X Pharmacist, Critical Care (Licence: FL PS52526) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302039491) |
| Enumeration Date | 2011-11-17 |
| Last Update Date | 2018-05-22 |