| NPI | 1033713169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: TN 41545) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: VA 0202216140) |
| Enumeration Date | 2020-11-30 |
| Last Update Date | 2020-11-30 |