| NPI | 1467410928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: CO 10209) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NE 8358) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2007-07-20 |