| NPI | 1447860473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 25092) |
| Additional Taxonomies | 1835G0303X Pharmacist Geriatric (Licence: MD 99108187) |
| Enumeration Date | 2020-08-04 |
| Last Update Date | 2020-08-04 |