| NPI | 1023367760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AL 20176) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 11486) |
| 183500000X Pharmacist (Licence: NH 2488) | |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2021-01-18 |