| NPI | 1306139290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PR 3748) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS27759) |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2018-11-28 |