| NPI | 1194856880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RPI000001) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP031377L) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2022-05-20 |