| NPI | 1225582653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH 3929) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 25822) |
| 183500000X Pharmacist (Licence: VT 033.0098925) | |
| Enumeration Date | 2016-08-15 |
| Last Update Date | 2016-10-21 |