| NPI | 1467442368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP034594L) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WV RP0012762) |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2021-10-10 |