| NPI | 1942396619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 028397) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 1-09136) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2025-09-11 |