| NPI | 1497275333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP451440) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 42557) |
| 183500000X Pharmacist (Licence: MN 123276) | |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2021-01-31 |