| NPI | 1013272467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ID P6689) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID CS19216) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2021-11-10 |