| NPI | 1215350574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC PH35384) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S017213) |
| Enumeration Date | 2014-01-22 |
| Last Update Date | 2020-01-30 |