| NPI | 1295102671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA 020957) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 54391) |
| Enumeration Date | 2015-09-01 |
| Last Update Date | 2023-01-09 |