| NPI | 1366950263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SD 6413) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 122926) |
| Enumeration Date | 2018-01-14 |
| Last Update Date | 2018-01-14 |