| NPI | 1952722654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NE 12649) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: AZ S019697) |
| Enumeration Date | 2013-12-23 |
| Last Update Date | 2013-12-23 |