| NPI | 1003996893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302021512) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: MI BCPS291115) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2007-07-08 |