| NPI | 1225569841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH 4285) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH236788) |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2017-04-10 |