| NPI | 1942400031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: MT 5351) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MT 5351) |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2014-09-08 |