| NPI | 1073951950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ND rph5639) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 119577) |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2021-06-15 |