| NPI | 1295739787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NC 15426) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: PA RP-045655-L) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2007-07-08 |