| NPI | 1205277894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 27544) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS50460) |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2025-02-07 |