| NPI | 1770773558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: TN 29386) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 29386) |
| 1835G0303X Pharmacist Geriatric (Licence: TN 29386) | |
| 1835N1003X Pharmacist Nutrition Support (Licence: TN 29386) | |
| 1835P1300X Pharmacist Psychiatric (Licence: TN 29386) | |
| 1835X0200X Pharmacist Oncology (Licence: TN 29386) | |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2007-07-27 |