| NPI | 1346850914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: AL 12367) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: TN 8304) |
| Enumeration Date | 2020-08-07 |
| Last Update Date | 2020-08-07 |