| NPI | 1295008555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ND RPH5258) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 119839) |
| Enumeration Date | 2012-02-17 |
| Last Update Date | 2021-06-09 |