| NPI | 1689960775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: OR 6653) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: CA 32823) |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2011-06-27 |