| NPI | 1184724668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: KY 012812) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: FL PS 32857) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: CO 16249) | |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2009-06-24 |