| NPI | 1285077271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO 16726) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: CO 16726) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: CO 16726) | |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2013-04-30 |