| NPI | 1114300662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ND RPH5814) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 122323) |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2019-08-13 |