| NPI | 1548576978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA 22850) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NH 2978) |
| Enumeration Date | 2010-08-23 |
| Last Update Date | 2019-03-14 |