| NPI | 1386664118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP036830L) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202205462) |
| 183500000X Pharmacist (Licence: MD 16197) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2018-08-03 |