| NPI | 1174950430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP447553) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP1007891) |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2021-03-29 |