| NPI | 1831513654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: GA RPH027173) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: NC 22680) |
| Enumeration Date | 2014-02-13 |
| Last Update Date | 2020-05-04 |