| NPI | 1407853286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 115547-5) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP-039755-T) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: MN 115547-5) | |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: PA RP-039755-T) | |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2007-07-08 |