| NPI | 1205941200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: MI 5302025189) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2007-07-08 |