| NPI | 1376540997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: KS 1-13350) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: TX 39513) |
| Enumeration Date | 2005-06-29 |
| Last Update Date | 2007-07-08 |