| NPI | 1538404959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OK 15028) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 51107) |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2022-08-16 |