| NPI | 1336559913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 010717) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: KY 307008443) |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2014-05-05 |