| NPI | 1457714750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS54756) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PR 6313) |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2020-11-20 |