| NPI | 1790016178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO 16977) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 1-13183) |
| Enumeration Date | 2010-01-25 |
| Last Update Date | 2024-06-24 |