| NPI | 1942682893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: TX 57909) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: GA RPH028421) |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2025-05-29 |