| NPI | 1811543366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: AZ S024583) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO PHA.0022803) |
| Enumeration Date | 2019-08-12 |
| Last Update Date | 2020-07-14 |