| NPI | 1083772057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 14927) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202204438) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2024-01-25 |