| NPI | 1457625782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NE 15727) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IA 23219) |
| Enumeration Date | 2012-03-05 |
| Last Update Date | 2018-05-16 |