| NPI | 1285901181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 16085-040) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IA 21898) |
| Enumeration Date | 2011-11-19 |
| Last Update Date | 2022-07-19 |