| NPI | 1467675108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 16909) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NV 16909) |
| 1835P2201X Pharmacist, Ambulatory Care (Licence: NV 16909) | |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2018-06-14 |