| NPI | 1467998088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: MO 2012042658) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: KS 1-16421) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: FL PS49184) | |
| Enumeration Date | 2017-01-07 |
| Last Update Date | 2017-01-07 |