NPI | 1497971246 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: SC 11220) |
Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: NC 18418) |
1835P1200X Pharmacist Pharmacotherapy (Licence: MA PH233915) | |
Enumeration Date | 2007-04-18 |
Last Update Date | 2012-07-12 |