| NPI | 1982797809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NC 15727) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: KY 8708) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2007-07-08 |