| NPI | 1811275662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: PA RP445572) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP445572) |
| Enumeration Date | 2011-07-28 |
| Last Update Date | 2022-07-06 |