| NPI | 1831276534 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: AZ 5470)  | 
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ 5470)  | 
| Enumeration Date | 2006-11-01 | 
| Last Update Date | 2025-09-11 |