| NPI | 1558760553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA 014691) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA 015295) |
| 183500000X Pharmacist (Licence: MS 106308) | |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2014-08-15 |