| NPI | 1033101787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PR 4586) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: PR 4586) |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2008-12-10 |