| NPI | 1558382275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 12009) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: NC 12009) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2017-01-18 |