| NPI | 1518246362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: MI 5302036484) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302036484) |
| Enumeration Date | 2011-08-10 |
| Last Update Date | 2015-05-30 |