| NPI | 1841017753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 74617) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: TX 74617) |
| Enumeration Date | 2024-09-23 |
| Last Update Date | 2024-12-03 |