| NPI | 1124303573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 18096) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: UT 8005979-1701) |
| Enumeration Date | 2011-10-18 |
| Last Update Date | 2020-10-29 |