| NPI | 1528578218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NE 10435) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SD 4574) |
| Enumeration Date | 2017-10-07 |
| Last Update Date | 2017-10-07 |