| NPI | 1467851386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: WI 17627-40) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 17627-40) |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2017-02-15 |