| NPI | 1306876941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835N1003X Pharmacist, Nutrition Support (Licence: FL PS24160) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: FL PS24160) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2007-07-08 |