| NPI | 1366734956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202007036) |
| Additional Taxonomies | 1835P2201X Pharmacist, Ambulatory Care (Licence: VA 0202007036) |
| Enumeration Date | 2011-05-14 |
| Last Update Date | 2025-04-28 |