| NPI | 1427076249 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: KS 1-14127) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: MO 2000163541) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2007-07-08 |