| NPI | 1326030933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: TX 40968) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH021872) |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2025-09-11 |