| NPI | 1073812186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS E-09994) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 16971) |
| Enumeration Date | 2011-03-15 |
| Last Update Date | 2020-12-03 |