| NPI | 1861498842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: FL ps20670) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: FL PU 5487) |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2023-06-19 |