| NPI | 1679871446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: OR 14540) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: ID P6341) |
| Enumeration Date | 2011-03-03 |
| Last Update Date | 2021-04-21 |