| NPI | 1114242559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AL 14086) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL 48690) |
| 183500000X Pharmacist (Licence: MS E-06911) | |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2020-11-09 |