| NPI | 1699181511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: AL 17481) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: TN 35918) |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2014-07-11 |