| NPI | 1427205335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OK 14839) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: AK PHAP2203) |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2023-09-11 |