| NPI | 1003460643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP453606) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RPI013177) |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2019-07-31 |