| NPI | 1992090153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: TN 34394) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: KY 015061) |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2011-06-16 |