| NPI | 1063874055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS60155) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH-0013316) |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2019-10-17 |