| NPI | 1922329440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: FL PS23710) |
| Additional Taxonomies | 1835G0303X Pharmacist Geriatric (Licence: FL PU4479) |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2010-06-18 |