| NPI | 1356313019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ND 4495) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 115414-6) |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2026-10-01 |