| NPI | 1386124352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 37642) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP030654L) |
| 183500000X Pharmacist (Licence: WV RP0004714) | |
| Enumeration Date | 2018-08-18 |
| Last Update Date | 2018-08-18 |