| NPI | 1457692733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: DC PH100000252) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: MD 19566) |
| Enumeration Date | 2013-03-11 |
| Last Update Date | 2013-03-11 |