| NPI | 1649767930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: PA RP451646) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP451464) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2022-07-06 |