| NPI | 1427158419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302035496) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL ps41158) |
| 1835C0207X Pharmacist, Compounded Sterile Preparations (Licence: DE A1-0004125) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2024-08-07 |