| NPI | 1114423662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S022369) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 72282) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2018-04-03 |