| NPI | 1245788413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S021763) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CT PCT.0013180) |
| 183500000X Pharmacist (Licence: MA PH235737) | |
| Enumeration Date | 2016-09-16 |
| Last Update Date | 2016-09-16 |