| NPI | 1366489478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: WI 12035-040) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: MN 115369-7) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2007-07-08 |