| NPI | 1285880666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835G0303X Pharmacist, Geriatric (Licence: MS T-010881) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH023879) |
| Enumeration Date | 2008-08-17 |
| Last Update Date | 2014-05-08 |