| NPI | 1013460302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 17364) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: NV 17364) |
| Enumeration Date | 2016-08-03 |
| Last Update Date | 2016-08-03 |