| NPI | 1952513301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: CA RPH 60284) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: GA RPH023160) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: MI 5302037341) | |
| Enumeration Date | 2007-05-05 |
| Last Update Date | 2011-11-10 |