| NPI | 1548639636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 18164) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 18164-40) |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2023-01-06 |