| NPI | 1134450638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: AZ S014742) |
| Additional Taxonomies | 1835P1300X Pharmacist, Psychiatric (Licence: AZ S014742) |
| 1835P2201X Pharmacist, Ambulatory Care (Licence: AZ S014742) | |
| Enumeration Date | 2010-01-22 |
| Last Update Date | 2022-02-17 |