| NPI | 1275535262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: AL 13195) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: GA 19749) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2012-10-18 |