| NPI | 1275909442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 24057) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MS E-13965) |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2020-09-23 |