| NPI | 1538361506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: MD D77458) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DE A1-0003326) |
| 183500000X Pharmacist (Licence: PA RP438344) | |
| 183500000X Pharmacist (Licence: MD 16832) | |
| 208600000X Surgery (Licence: DE C7-0003801) | |
| 2086S0129X (Licence: DE C1-0011411) | |
| 2086S0129X (Licence: OK 37936) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2024-02-01 |