| NPI | 1144679309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NM RP00010085) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302033746) |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2024-08-04 |