| NPI | 1730196270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IA 13944) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: SD R4381) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2007-07-08 |