| NPI | 1306213590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR 0014830) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID P7926) |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2022-04-19 |