| NPI | 1689734618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PX30118) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: FL PS30118) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2020-02-04 |