| NPI | 1083941157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO 20241) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ 18310) |
| Enumeration Date | 2009-11-11 |
| Last Update Date | 2020-09-16 |