| NPI | 1598288227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 36635) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WV RP0009337) |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2017-07-25 |