| NPI | 1508867920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: GA 021828) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: FL PS37122) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2007-07-08 |