| NPI | 1104809441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 011237) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 22941) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2024-07-24 |