| NPI | 1336674548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MT 3547) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: UT 85679551701) |
| 183500000X Pharmacist (Licence: AZ S020529) | |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2017-04-25 |