| NPI | 1336595743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 47137) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 33341) |
| Enumeration Date | 2016-05-05 |
| Last Update Date | 2022-10-14 |