| NPI | 1205163904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MA PH232812) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: MA PH232812) |
| Enumeration Date | 2009-11-17 |
| Last Update Date | 2009-11-17 |