| NPI | 1538605886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 18510-40) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO PHA21384) |
| 183500000X Pharmacist (Licence: WY 3949) | |
| Enumeration Date | 2017-01-10 |
| Last Update Date | 2017-01-10 |