| NPI | 1700140399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835G0303X Pharmacist, Geriatric (Licence: OK 6594) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OK 6594) |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2024-05-11 |