| NPI | 1033326426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 15498) |
| Additional Taxonomies | 1835G0303X Pharmacist Geriatric (Licence: MD 15498) |
| 1835P1200X Pharmacist Pharmacotherapy (Licence: MD 15498) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2007-07-08 |