| NPI | 1598290330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH236107) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP449597) |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2017-05-01 |