| NPI | 1164423158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OK 15163) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: OK 15163) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2019-02-18 |