| NPI | 1609107374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ 15550) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA 02762) |
| 183500000X Pharmacist (Licence: ID P7348) | |
| 183500000X Pharmacist (Licence: MA PH236255) | |
| 183500000X Pharmacist (Licence: WV RP0009388) | |
| 183500000X Pharmacist (Licence: MS T13162) | |
| Enumeration Date | 2010-01-20 |
| Last Update Date | 2017-06-15 |