| NPI | 1467863811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: AZ 3154673) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S020597) |
| Enumeration Date | 2014-05-19 |
| Last Update Date | 2023-06-26 |