| NPI | 1265950109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC NC27059) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 27059) |
| 1835G0303X Pharmacist, Geriatric (Licence: NC 99108348) | |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2025-01-08 |