| NPI | 1194046573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 014951) |
| Additional Taxonomies | 1835G0303X Pharmacist Geriatric (Licence: KY 014951) |
| Enumeration Date | 2010-06-19 |
| Last Update Date | 2018-10-10 |