| NPI | 1801201058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2011026601) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: MO 2011026601) |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2014-06-26 |