| NPI | 1265765176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP443896) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RPI001400) |
| Enumeration Date | 2009-09-09 |
| Last Update Date | 2020-11-23 |