| NPI | 1306110580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO 19765) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS45146) |
| 183500000X Pharmacist (Licence: IN 26023181A) | |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2021-10-12 |