| NPI | 1679781124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: UT 5932264-1701) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2007-07-08 |