| NPI | 1083048235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 18662) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S020091) |
| Enumeration Date | 2013-08-23 |
| Last Update Date | 2022-08-04 |