| NPI | 1003150848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S019570) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2013006897) |
| Enumeration Date | 2012-11-17 |
| Last Update Date | 2020-03-29 |