| NPI | 1851373849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NM RP00006782) |
| Additional Taxonomies | 1835N1003X Pharmacist, Nutrition Support (Licence: NM RP0006782) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: NM RP00006782) | |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2007-07-08 |