| NPI | 1871742403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: IA 20581) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IA 20581) |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2021-12-20 |