| NPI | 1043328560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: AZ 13659) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: IN 26020781A) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2020-03-25 |