| NPI | 1962716357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835G0303X Pharmacist, Geriatric (Licence: NC 21203) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: KS 14855-1) |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2020-12-01 |