| NPI | 1477035251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ID P8077) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH-0016755) |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2018-08-29 |