| NPI | 1063580751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: ND Rph5068) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ND 5068) |
| 183500000X Pharmacist (Licence: MN 118538) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2025-01-29 |