| NPI | 1548665839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 19749) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP442083) |
| Enumeration Date | 2014-10-29 |
| Last Update Date | 2025-02-11 |