| NPI | 1225444037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 60370) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S020567) |
| 183500000X Pharmacist (Licence: FL PS53042) | |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2020-04-29 |