| NPI | 1316237985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: KY 014870) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: WV RP0007437) |
| 1835P1200X Pharmacist Pharmacotherapy (Licence: OH 031274941) | |
| Enumeration Date | 2011-04-15 |
| Last Update Date | 2011-04-15 |