| NPI | 1356378608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NE 11758) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: IA 19656) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2022-03-10 |