| NPI | 1245367606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NM RP00008824) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM RP00008824) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: IN 26014923A) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2021-10-15 |