| NPI | 1043628043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: TN 29433) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: AL 16156) |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2014-07-23 |