| NPI | 1699021188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835G0303X Pharmacist, Geriatric (Licence: TN 36874) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 36874) |
| Enumeration Date | 2012-08-02 |
| Last Update Date | 2018-10-01 |