| NPI | 1659388007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NM RP00006206) |
| Additional Taxonomies | 174400000X Specialist (Licence: NM PC-00000101) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2018-03-17 |