| NPI | 1578119228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP452968) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RPI012709) |
| Enumeration Date | 2019-08-16 |
| Last Update Date | 2020-10-20 |