| NPI | 1821126228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835G0303X Pharmacist, Geriatric (Licence: MD 13684) |
| Additional Taxonomies | 1835N1003X Pharmacist, Nutrition Support (Licence: DC ph2303) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: VA 0202005165) | |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2007-07-08 |