| NPI | 1366724627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH26635) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA 10193) |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2020-11-01 |