| NPI | 1306390802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA ph234111) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA rp449414) |
| Enumeration Date | 2016-08-12 |
| Last Update Date | 2018-08-20 |