| NPI | 1609199546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 14771-040) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302033992) |
| Enumeration Date | 2010-03-06 |
| Last Update Date | 2023-04-17 |