| NPI | 1215222831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202221894) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 17302) |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2025-08-30 |