| NPI | 1841773041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: UT 7343428-1701) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH-0016103) |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2019-07-23 |