| NPI | 1497707137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OK 10512) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: OK 105125) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2016-03-11 |