| NPI | 1891994380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: TX 45195) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 45195) |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2007-07-13 |