| NPI | 1093791428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835G0303X Pharmacist, Geriatric (Licence: AL 12907) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: AL 12907) |
| Enumeration Date | 2005-12-18 |
| Last Update Date | 2025-09-11 |