| NPI | 1831679133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: MO 2018031225) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 1-15241) |
| 183500000X Pharmacist (Licence: UT 6310785-1701) | |
| 183500000X Pharmacist (Licence: NC 21803) | |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: NC 3122077) | |
| Enumeration Date | 2018-08-16 |
| Last Update Date | 2020-05-21 |