| NPI | 1346559234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MT 6638) |
| Additional Taxonomies | 286500000X Military Hospital (Licence: MT 6638) |
| Enumeration Date | 2010-09-27 |
| Last Update Date | 2023-11-13 |