| NPI | 1538469333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MT 6275) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO 18791) |
| 183500000X Pharmacist (Licence: WY 3903) | |
| Enumeration Date | 2010-10-26 |
| Last Update Date | 2022-07-28 |