| NPI | 1508349465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR RPH0016834) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: UT 10120119-8911) |
| 183500000X Pharmacist (Licence: UT 10120119-1701) | |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2023-08-10 |