| NPI | 1144578527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT PCT.0012259) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: CT PCT.0012259) |
| 183500000X Pharmacist (Licence: TX 56530) | |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2022-02-18 |