| NPI | 1003115288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL 58561) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP446842) |
| Enumeration Date | 2011-03-27 |
| Last Update Date | 2021-02-03 |