| NPI | 1083695811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: IL 051039436) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: CO 14645) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2008-10-07 |