| NPI | 1376079004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ID P6693) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH-0013943) |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2017-05-01 |