| NPI | 1902631062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist Ambulatory Care (Licence: MD 29503) |
| Additional Taxonomies | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MD 29503) |
| Enumeration Date | 2024-09-06 |
| Last Update Date | 2024-09-06 |