| NPI | 1942557269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: IA 22020) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: AL P17165) |
| Enumeration Date | 2012-08-06 |
| Last Update Date | 2013-07-25 |