| NPI | 1881912319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: MN 118316) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 118316) |
| Enumeration Date | 2010-05-07 |
| Last Update Date | 2011-03-17 |