| NPI | 1467729079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 51161) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR 0012882) |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2022-07-21 |