| NPI | 1457628901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2008029243) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IA 20063) |
| Enumeration Date | 2011-11-29 |
| Last Update Date | 2023-09-08 |