| NPI | 1740592930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: DC 3140525S) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 054576) |
| 183500000X Pharmacist (Licence: OR 0019083) | |
| 183500000X Pharmacist (Licence: HI 3993) | |
| 183500000X Pharmacist (Licence: CA 70844) | |
| 183500000X Pharmacist (Licence: MA 233371) | |
| 183500000X Pharmacist (Licence: VT 033.0135171) | |
| Enumeration Date | 2010-07-05 |
| Last Update Date | 2025-09-28 |