| NPI | 1255489522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 11051-040) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 114361-0) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2023-03-07 |