| NPI | 1568829141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835G0303X Pharmacist, Geriatric (Licence: KS 1-14856) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: MO 2008027503) |
| Enumeration Date | 2016-01-27 |
| Last Update Date | 2016-01-27 |