| NPI | 1407144504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S016691) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID 8792) |
| 183500000X Pharmacist (Licence: CO PHA.0019752) | |
| 183500000X Pharmacist (Licence: WA PH60883540) | |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2020-09-02 |