| NPI | 1538166426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NC 11048) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: AL 14350) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2022-07-21 |