| NPI | 1477829463 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 183500000X Pharmacist (Licence: PR 1707)  | 
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: PR 1707)  | 
| Enumeration Date | 2012-03-24 | 
| Last Update Date | 2012-03-24 |