| NPI | 1649342403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: WA ph40408) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: ID p5412) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: OR RPH-0015709) | |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2021-10-01 |