| NPI | 1992035661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: FL ps36946) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: TX 45163) |
| Enumeration Date | 2009-12-31 |
| Last Update Date | 2009-12-31 |