| NPI | 1619220183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 16302-40) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302041433) |
| Enumeration Date | 2012-10-22 |
| Last Update Date | 2020-03-29 |