| NPI | 1366773111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: UT 4753323-1701) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S013723) |
| Enumeration Date | 2010-01-19 |
| Last Update Date | 2022-07-29 |