| NPI | 1164791695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS45490) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: FL PS45490) |
| Enumeration Date | 2011-12-29 |
| Last Update Date | 2017-04-21 |