| NPI | 1487009205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS36568) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 48543) |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2021-10-05 |