| NPI | 1508266180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NM 9921) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 82074) |
| 183500000X Pharmacist (Licence: SC 35740) | |
| 183500000X Pharmacist (Licence: CT 11980) | |
| Enumeration Date | 2014-09-02 |
| Last Update Date | 2023-12-26 |