| NPI | 1790782746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835G0303X Pharmacist, Geriatric (Licence: IA 16098) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: MT PHA-PHA-LIC-15330) |
| Enumeration Date | 2005-07-06 |
| Last Update Date | 2024-01-31 |