| NPI | 1023307964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA 020184) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202-012860) |
| 183500000X Pharmacist (Licence: NV 13959) | |
| Enumeration Date | 2011-03-31 |
| Last Update Date | 2018-08-01 |