| NPI | 1457657207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: ME PR5502) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: DC 100000633) |
| 1835P1200X Pharmacist Pharmacotherapy (Licence: GA RPH023747) | |
| Enumeration Date | 2011-01-26 |
| Last Update Date | 2011-01-26 |