| NPI | 1700881604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NC 13011) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 13011) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2010-03-22 |