| NPI | 1053781724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP443990) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RPI001729) |
| Enumeration Date | 2015-10-06 |
| Last Update Date | 2022-01-26 |