| NPI | 1942359690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: AZ 12432) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: MT 3960) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2007-07-08 |