| NPI | 1497033377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: WI 12056-40) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: WI 390200000X) |
| Enumeration Date | 2011-07-27 |
| Last Update Date | 2024-03-01 |