| NPI | 1407168578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202211639) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WV RP0008037) |
| 183500000X Pharmacist (Licence: TX 46576) | |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2023-09-08 |