| NPI | 1124318142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 17868) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NC 17686) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: NC 17868) | |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2011-04-11 |