| NPI | 1205942133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: AZ S015450) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ 15450) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2014-11-28 |