| NPI | 1568499648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: AK 1305) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: AZ S11706) |
| 1835P1200X Pharmacist Pharmacotherapy (Licence: CA RPH49027) | |
| 1835P1200X Pharmacist Pharmacotherapy (Licence: NV 13341) | |
| 1835P1200X Pharmacist Pharmacotherapy (Licence: HI PH1838) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2007-07-08 |