| NPI | 1265768477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: MN 119412) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 119412) |
| Enumeration Date | 2009-10-22 |
| Last Update Date | 2024-01-11 |