| NPI | 1659501245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 33570) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202210507) |
| 183500000X Pharmacist (Licence: FL PS0044823) | |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2022-12-19 |