| NPI | 1275721128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: MT 3980) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: AK 1733) |
| Enumeration Date | 2007-10-04 |
| Last Update Date | 2016-11-04 |