| NPI | 1609913383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SD 4424) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ND RPh4475) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2016-01-06 |