| NPI | 1336675818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ND RPh5600) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 121238) |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2017-05-03 |