| NPI | 1407207228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 119675) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 114697) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2021-03-10 |