NPI | 1700870748 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: MD 11708) |
Additional Taxonomies | 1835N1003X Pharmacist, Nutrition Support (Licence: MD 11708) |
1835P1200X Pharmacist, Pharmacotherapy (Licence: MD 11708) | |
Enumeration Date | 2005-09-06 |
Last Update Date | 2007-07-08 |