| NPI | 1215923032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PR 5005) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 46856) |
| 183500000X Pharmacist (Licence: FL PS39843) | |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2021-07-27 |