| NPI | 1932388964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: TX 64060) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH023730) |
| Enumeration Date | 2007-10-26 |
| Last Update Date | 2019-10-02 |