| NPI | 1104927805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: PA RP044870L) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP044870L) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2020-06-03 |