| NPI | 1235337189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 56338) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID P5608) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2020-12-09 |