| NPI | 1063429454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: IN 26018410A) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: AZ 8372) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2007-07-08 |