| NPI | 1235331653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: MI 5302034721) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: PA RP437847) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2007-08-06 |