| NPI | 1487065249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S015549) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302035451) |
| Enumeration Date | 2014-05-15 |
| Last Update Date | 2020-02-03 |