| NPI | 1962817346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: MO 041601) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: KS 1-11254) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: CO 16739) | |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2014-08-04 |