| NPI | 1275838377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 012342) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS39415) |
| Enumeration Date | 2011-01-20 |
| Last Update Date | 2023-02-23 |