| NPI | 1285971051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH PHCY-04586) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 27624) |
| 183500000X Pharmacist (Licence: FL PS46972) | |
| Enumeration Date | 2013-01-13 |
| Last Update Date | 2020-11-06 |