| NPI | 1013252006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: OR RPH0012435) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: WI 15970-40) |
| Enumeration Date | 2012-12-03 |
| Last Update Date | 2012-12-03 |