| NPI | 1093797219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: GA RPH022455) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: FL PS39741) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: PA RP040267L) | |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2008-06-15 |