NPI | 1114928496 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: OK 12884) |
Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: OK 12884) |
Enumeration Date | 2005-08-09 |
Last Update Date | 2007-07-08 |