| NPI | 1376730721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 11758) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: SC 11758) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2013-07-10 |