| NPI | 1669813044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH234299) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 53138) |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2023-09-28 |