| NPI | 1659398121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NV 12572) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: CA 48274) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2013-07-03 |