| NPI | 1043885841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835G0303X Pharmacist, Geriatric (Licence: TX 22829) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: TX 22829) |
| Enumeration Date | 2021-05-24 |
| Last Update Date | 2021-05-24 |