| NPI | 1306479522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP447363) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 10834) |
| 183500000X Pharmacist (Licence: NC 17166) | |
| Enumeration Date | 2020-02-17 |
| Last Update Date | 2020-02-17 |