| NPI | 1265785430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA 019677) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MS E-12301) |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2020-12-15 |