| NPI | 1396963492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: MO 1999139749) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: IL 051-034015) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: MI 24022) | |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2007-07-08 |