| NPI | 1215206636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: MI 291184) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302025014) |
| Enumeration Date | 2011-12-14 |
| Last Update Date | 2011-12-14 |