| NPI | 1407171606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-14265) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: MO 2009017116) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: NC 20783) | |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2010-03-30 |