| NPI | 1295273894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 18217-40) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 122730) |
| Enumeration Date | 2017-02-03 |
| Last Update Date | 2018-10-31 |