| NPI | 1013293851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: CT 0010122) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: CO PHA.0015581) |
| Enumeration Date | 2011-10-25 |
| Last Update Date | 2026-08-05 |