| NPI | 1265833560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH 3996) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH240150) |
| 183500000X Pharmacist (Licence: VA 202219819) | |
| Enumeration Date | 2014-09-06 |
| Last Update Date | 2021-08-10 |