| NPI | 1629324934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP452238) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IA 22408) |
| 183500000X Pharmacist (Licence: NC 22518) | |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2018-07-09 |