| NPI | 1497115141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP451389) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202210793) |
| Enumeration Date | 2016-02-23 |
| Last Update Date | 2020-10-13 |