| NPI | 1295860260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IA C16897) |
| Additional Taxonomies | 1835P2201X Pharmacist, Ambulatory Care (Licence: IA 16897) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2018-06-16 |