| NPI | 1285969550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 63769) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 16867) |
| Enumeration Date | 2009-10-05 |
| Last Update Date | 2024-09-10 |