| NPI | 1225695125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: NH R1140) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NH R1140) |
| Enumeration Date | 2019-05-26 |
| Last Update Date | 2019-05-26 |