| NPI | 1225413974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 122568) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 18055-40) |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2023-12-22 |