| NPI | 1477994077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: AZ S019992) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: FL PS49692) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: OK R-15802) | |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2016-04-21 |