| NPI | 1063786598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC NC18197) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP039925L) |
| Enumeration Date | 2012-03-01 |
| Last Update Date | 2022-07-21 |