| NPI | 1518210897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP445387) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RPI004555) |
| 183500000X Pharmacist (Licence: AZ S022301) | |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2017-03-17 |