| NPI | 1639133689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: CA 44418) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: HI 1535) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2022-07-21 |