| NPI | 1275037061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: TX 57949) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: IN 26020324) |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2018-03-19 |